Newsgroups: soc.culture.indian
Path: ultb!ultb!glp5941
From: glp5941@ultb.rit.edu (Greg Pratt)
Subject: AIDS Epidemic in India [ARTICLE]
Message-ID: <1991Dec17.191059.15973@isc.rit.edu>
Keywords: AIDS, discrimination, medicine
Sender: news@isc.rit.edu (USENET News System)
Nntp-Posting-Host: ultb
Reply-To: glp5941@ultb.rit.edu (Greg Pratt)
Organization: Rochester Institute of Technology, Rochester, NY [USA]
Date: Tue, 17 Dec 91 19:10:59 GMT
The following article was typed in from Issue 590 (November 19, 1991) of
_The_Advocate_, a well-known gay and lesbian magazine in the United States
(and without their permission). Naturally, there may be a couple of
unresolved typos (I already found one, but it was copied verbatim from
_The_Advocate_; they apparently screwed up the spelling of "Gautam").
This article is a little scary. Again, I am sure that there are many people
who will shrug it off, but hopefully some of you out there might become at
least a little more aware of what is happening in India, right under the
noses of many unsuspecting people.
This article is quite long; however, PLEASE read it as you are able. I'll
refrain from any further comments for now, as I would like for people to
judge it in its own right. However, please keep in mind this article is,
even in my view somewhat biased (not that it isn't a little bit needed).
_The_Advocate_ is mainly a gay publication, and because the gay community has
been hit so hard by AIDS, most people within that community (including
myself) do not have a lot of pity on people who are looking to get rid of
AIDS by isolating the people who "supposedly" are the primary carriers.
(Send me e-mail rather than a public reply if you wish to debate that opinion
specifically.)
India Fights AIDS with Prisons and Chains
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Ignorance Keeps South Asia at the Mercy of the Epidemic
by Arvind Kumar
Churachandpur is a small, sleepy town about 40 miles south of Imphal,
the capital of Manipur State in India. This mountainous region in the
remote, easternmost part of India lies on the border with Myanmar
(formerly known as Burma). In between the heavily forested hillsides
are rich, fertile valleys full of paddy fields, where heavy monsoon
rains create an ideal environment for growing rice.
With only 2 million residents, Manipur is one of the least populated
states in India. The problems of poverty and overpopulation that
plague the rest of the country do not seem to effect Manipur quite as
much. But in Churachandpur, the administrative center of the Manipur
South district, there are other problems.
The Gamnaum Christian Home in town holds some 85 patients, all of whom
have tested positive for HIV, the suspected AIDS virus. At this
rehabilitation center, something is desperately wrong. Here the
patients spend their days and nights in chains. Their hands and feet
are shackled to prevent escape. There is no treatment, no therapy for
them -- only prayers and lots of copies of the Bible.
This is a privately run medical care facility funded by one of the many
evangelical Christian organizations that operate in India. Intravenous
drug addicts are supposed to receive care and treatment here.
None of the inmates have developed full-blown AIDS. They have only
tested positive for HIV. It is generally known that merely testing
positive does not mean the individual will develop AIDS immediately.
But medical knowledge of this sort is not widely available in
Churachandpur. The authorities at the Gamnaum Christian Home say they
are afraid that the inmates might escape, go back to drugs, engage in
unsafe sex, and further spread the disease. Hence the shackles.
There are big and small Churachandpurs all over India, where
HIV-positive men and women are being denied treatment and jailed.
People suffering from full-blown AIDS are dying because they are being
refused treatment of any kind.
LITANY OF EVILS
~~~~~~~~~~~~~~~
At the All India Institute of Medical Sciences (AIIMS) in New Delhi,
India's premier hospital and medical institution with the best doctors
and the most advanced facilities for medical care and treatment, there
has emerged a pattern of AIDS phobia and discrimination.
Senior doctors at AIIMS were scheduled to perform a lifesaving
operation on an African envoy on Jan. 15, 1990. However, on finding
out that the patient was HIV-positive, doctors refused to perform the
operation, an organ transplant. The envoy died five days later. The
_Times_of_India_ newspaper broke the story on Jan. 19, 1990, and it
created an immediate uproar. The Health Ministry was force to launch
an inquiry into the incident, but little came of it. Policy at the
hospital remained unchanged.
When Venit and Rohit Oberoi, two brothers who have suffered from
hemophilia since birth, became infected with HIV in July 1990, they
were referred to AIIMS, which had received a special $80,000 grant for
an AIDS unit. _Indian_Express_ reported, "Vinit's blood samples have
been returned untested by the laboratories, nurses have jeered at him,
and doctors have asked them to stay away from them." The brothers went
public with their story, even appearing on Doordarshan, the national
television network, but to no avail. To this day, they continue to be
shunned by the medical establishment in India.
Last August, a pregnant woman from Arga was admitted to AIIMS but was
refused treatment when it was found that she was HIV-positive. The
head of gynecology, Dr. Kamal Bakshi, decided to go on leave as the
patient was going into labor. The head of AIDS research, Dr. A.N.
Malviya, claimed his department did not have the facilities to treat
HIV-positive patients.
In Bombay, about 30 kidney patients have been refused the dialysis they
need to live because they test HIV-positive. The cruel irony of their
cases is that they are now being turned away by the same hospitals
where they were infected in the first place. Also in Bombay, a
3-month-old HIV-positive infant died at the Sir Jamshedji Jejahoy
Hospital last August because no doctor or nurse would agree to tend
her.
FEAR AND DENIAL
~~~~~~~~~~~~~~~
"AIDS is still seen here as a disease of the poor, the illiterate, the
prostitutes, and the deviants," explains Dr. Ishwar Satyanarayan Gilada
of the International Health Organization, a group formed by hundreds of
concerned Indian doctors. Based in Bombay, Gilada is regarded by many
to be India's top AIDS expert. "I hate to say it, but we need an
Indian Rock Hudson to die here before this attitude will change."
And attitudes in India are slow to change. Centuries of Islamic and
British rule have left their mark: To even talk about sex in public is
taboo.
This is why a sexually transmitted disease like AIDS is proving to be
doubly traumatic for a society like India's. The trauma is far from
over; it has only begun.
The statistics are alarming. According to a World Health Organization
(WHO) report, the government's own estimates of HIV infection in India
have been revised this year with an almost hundredfold increase: from
4,515 cases at the beginning of the year to between 300,000 and
400,000. The actual number is believed to be close to 1 million and
growing, according to WHO.
"The conditions are here for and AIDS epidemic as bad as the one in
Africa," says Dr. H. L. Sell, regional advisor on health and behavior
at the WHO office in Delhi.
"AIDS will play anarchy in India," warns Gilada. "It will be chaos
everywhere. And even now, no one seems to care enough to do anything
to control it."
Unfortunately, most efforts by government and health authorities have
been in the direction of testing, surveillance, and criminalization of
the disease rather than prevention or cure.
`WANTED FOR AIDS' posters carrying names and photographs of known
HIV-positive individuals adorn the walls of the Lok Nayak Jaya Prakash
Hospital in New Delhi and are even posted on some city streets. "AIDS
in India is being treated like a crime, not an illness," says Dr. Bindu
Desai of India Alert, a Chicago-based human rights organization.
In the absence of a clearly formulated AIDS policy, bigots of all
persuasions -- homophobes and misogynists, to name two -- are
formulating public policy with no supervision. The best known example
of this is Dr. A.S. Paintal, the ex-director general of the powerful
Indian Council of Medical Research (ICMR) in New Delhi. He has been
vocal and unapologetic in his views, singling out women as a "lousy
lot...having AIDS being poured into them because they did not stop
cohabiting with foreigners." Paintal has also claimed that there are
no homosexuals in India.
More than a decade after the emergence of AIDS, there is still no
systematic screening of blood and blood products in private clinics,
blood banks, and public hospitals in India.
The Indian government has allocated significant resources towards AIDS
research and prevention. In 1990 it set aside $15 million over the
next three years for an AIDS control and prevention program. It has
also funded 40 test centers in the five major cities of India: Delhi,
Bombay, Calcutta, Madras, and Bangalore. But many of these test
centers exist only on paper. As of this writing, only one of the eight
sanctioned centers in Bombay was up and running.
The AIDS ward in AIIMS consists of only two beds. "Even those two beds
usually remain empty," charges Siddhartha Guatam, and AIDS activist in
New Delhi, "because those who need them are not being admitted."
It is not clear that the funds allocated for AIDS research are being
used for that purpose. The _Times_Of_India_ reported that leading
health authorities, including members of ICMR, concluded that AIDS
prevention in India was best pursued through India's knowledge of
"religious scriptires...and yoga practices." "For the Indian Council
of Medical Research to say this," counters Gautam angrily, "is highly
irresponsible."
INDIAN PRIDE
~~~~~~~~~~~~
Indians pride themselves on being the oldest living civilization in the
world. But in the 20th century, India seems to be struggling to find
its place in the world. More than 40 years after winning its
independence from Britain, its problems are far from solved.
Secessionist struggles rage in Kashmir, Punjab, and Assam.
Hindu-Muslim rivalry and religious riots are all too frequent. The
problems of poverty, illiteracy, and hygiene remain acute.
The arrival of a lethal and incurable disease such as AIDS clearly
caught the country off guard. India's first encounter with AIDS took
place five years ago, when a person infected by a blood transfusion
during heart surgery in the United States, died of complications from
AIDS in July 1986. "Since the beginning, when the first AIDS case
showed up here," charges Gilada, "the government has taken a
head-in-the-sand attitude toward this disease."
The government's own HIV screening program did not begin until October,
1985. Until four years later, only 2,167 people had tested positive
for antibodies to HIV. Medical experts insisted that the government's
figures had no relation to reality.
As late a 1988, Paintal, the government's chief medical researcher, was
proposing a law to ban sex between Indians and foreigners. "The
African nations weren't careful," he was quoted as saying at the time.
"The foreigners gave it to them, and now they're giving it to us." A
barrage of domestic and international criticism put a stop to his
proposal.
When Goa, the internationally known beach resort state, recorded its
first AIDS case in 1989, the state government immediately enacted a law
that permitted the testing of any Indian or foreigner suspected of
being HIV-positive. Those who tested positive could be isolated in a
hospital or prison.
Dominic de Souza, a Goan employee of the World Wildlife Fund, was found
to be HIV-positive and was kept in solitary confinement at the local
police station for an entire month. Public protests by Gilada's
organization secured not only the release of de Souza but also the
repeal of the draconian law.
What concerns Indian AIDS activists now is the proposed AIDS Prevention
Bill that the government has been trying to pass since 1989. If
passed, the bill would enable health authorities forcibly test,
isolate, and detain any HIV-positive person or anyone even suspected of
being HIV-positive; it would not require authorities to inform those
tested about the nature of the test or its results.
"This is a foolish, hysterical response to a major public health
challenge," charges Gautam, a lawyer at the Delhi High Court. "It is a
classic case of a medical problem being used to further a puritanical,
moralistic, antipeople agenda."
A similar bill is up before the Legislative Council in Maharashtra
State, home to India's second largest city, Bombay. The bill calls for
the arrest and segregation in detention camps of those found to be HIV
positive.
The secessionist National Socialist Council of Nagaland, a political
group seeking human and civil rights in several northeastern provinces,
has taken the ultimate step. After a three-day council meeting at its
regional headquarters in Imphal, it announced on January 15, 1991, that
if the group attains majority political power, all prostitutes and drug
addicts suffering from AIDS in Manipur and other northeastern states of
India would be executed. "It is shocking," admits Gautam. "It shows
the kind of extreme fear that still prevails in India about AIDS."
FIGHTING BACK
~~~~~~~~~~~~~
The impetus for a positive response to the AIDS crisis is coming not
from the government or the medical establishment but rather from small
nongovernmental organizations. Some of these are based in India and
work on a volunteer basis on public-interest issues. Similar
organizations of Indian expatriates in the West have also pitched in.
Together, they are playing the crucial role of watchdog.
Perhaps the most significant of these is the Delhi-based group AIDS
Bhedbhav Virodhi Andolan (ABVA, the AIDS Antidiscrimination Movement),
which was formed in late 1988 with the goal of providing support to
HIV-positive individuals and lobbying for better medical care on their
behalf.
"For a small, all-volunteer group such as ours," says Gautam, one of
seven core members of ABVA, "it's a major struggle. Still, we have
been able to put a lot of pressure on the government concerning AIDS."
On the eve of World AIDS Day (Dec. 1) of last year, ABVA organized a
demonstration in front of the offices of the Medical Council of India
to protest the mistreatment of HIV-positive and AIDS-affected
individuals in Indian hospitals. Some 200 protesters carried placards
with slogans such as `DO NOT MOURN PEOPLE WITH AIDS, JOIN THEM IN THE
BATTLE'.
ABVA constantly monitors the mistreatment of AIDS patients at local
hospitals and writes letters of protest. It recently drew attention to
the New Delhi Municipal Corporation Hospital's dismal record of
infecting 17 out of 56 hemophiliac children with tainted blood.
A group of concerned Indians in the United States has been watching
developments in India with mounting concern. When Rachna Kamtekar, an
India Alert member, visited India, she ran into Gautam and took a whole
dossier of AIDS-related material with her back to Chicago. What she
and other members saw convinced them that they had to get involved.
They began circulating petitions and letters of protest to various
government bodies and hospitals in India, urging better care for
HIV-positive and AIDS patients.
This summer, on a visit to Great Britain and the United States, Gautam
met with Indians active in the local AIDS organizations in London and
New York, he convinced them that something had to be done to put
pressure on the Indian government. The result was a series of
simultaneous protests at Indian embassies around the world: London,
Toronto, New York, Chicago, and San Francisco. The date of the
protests, Aug. 13, was chosen for its proximity to the anniversary of
India's independence on Aug. 15, 1947.
"The discrepancies between official and unofficial estimates [of HIV
infection in India] galvanized us," says Harsha Ram, a member of the
South Asian AIDS Action of New York. "At this rate, India could become
the next major scene for AIDS in the world."
"We need to learn that AIDS is a disease, not a crime," says India
Alert's Desai, who helped organize the protest outside the Indian
consulate in Chicago. "The outlook on AIDS in India is extremely grim.
We are sitting on top of a volcano."
COMING OUT
~~~~~~~~~~
The recent protests have also drawn openly gay and lesbian South
Asians. (South Asian is the modern term for the Indian subcontinent.
It consists of countries such as India, Pakistan, Bangladesh, Nepal,
Bhutan, and Sri Lanka. South Asia is often confused with, but very
distinct from, Southeast Asia, which encompasses countries such as
Malaysia, Indonesia, the Philippines, Cambodia, Laos, and Vietnam).
Organized gay and lesbian groups of South Asians were unknown as
recently as 1985. In a society that is afraid to discuss
heterosexuality, homosexuality may as well not exist. The old British
law making sodomy a crime punishable by a life sentence still remains
part of the Indian penal code.
India's first gay and lesbian group made its debut in Bombay in 1990
with a magazine called _Bombay_Dost_, while gay and lesbian support
groups formed in New Delhi, Calcutta, and Madras. India's gay and
lesbian revolution was not restricted to its major cities. A
publication called _Freedom_ began publishing from the small town of
Gulbarga in Karnataka State around the same time.
Some changes have been evident in the Indian government's approach to
AIDS in recent months. "The rhetoric has changed slightly," says
Gautam, pointing to the government's new media campaign that carries
messages such as "Kissing and hugging do not spread AIDS."
AIDS-prevention posters and advertisements are now beginning to suggest
the use of condoms as protection against the virus. "For the Indian
government, this is a radical shift," Gautam notes.
WHO's Sell is more upbeat. His organization has just applied for a
$55-million World Bank loan for AIDS prevention in India. He takes a
kinder view of the human rights abuses that have occurred in India.
"Every government in the world has gone through the phases of denial
and horror about AIDS," he says. "The problem is not unique to India.
Now the climate [in India] is very good for intervention because
everyone is taking AIDS very seriously."
If the World Bank loan comes through, Gautam says, "We are pushing for
assurances from the government that all this money won't go towards
just saleries, that some of it will actually be used for AIDS
prevention, screening of blood products, etc."
India's first group for people with AIDS is being formed by de Souza.
Despite the small gains, India is not yet safe for those who are
HIV-positive. "Sending HIV-positive individuals to a government
hospital may be the worst thing for them," Gautam says. What
disappointed him most has been the medical community's response to
AIDS. "Doctors have been at the forefront of spreading misinformation
about AIDS in India," he charges. "They have blamed prostitutes, blood
donors, and all other marginalized groups in society for AIDS without
any statistical data to back up their claims."
Now there is additional cause for concern, not from within India but
from abroad. ABVA has learned that WHO is looking for a site to test
an AIDS vaccine. The vaccine, which will most probably be developed in
European labs, will most likely be tested on humans in Africa or India.
A WHO source who declined to be named says that a team has already
visited India to search for possible sites.
ABVA is strongly opposed to the trials. "Indians are being targeted as
guinea pigs," says Gautam, noting that the target population will
almost certainly be picked from the lower classes of Indian society and
will be given little or no say in the testing process.
At the August demonstration in San Francisco, there was a sense or
urgency. "I feel very strongly about what is happening," said Nina
Kabir, a Bangladeshi. "If we don't act now, it'll be too late."
"It is already too late," says Gautam. "I feel quite pessimistic."
But other activists remain optimistic. They believe they can change
the world by trying. They may not be able to check the spread of the
virus, but they may yet be successful in awakening our sense of
compassion and fairness. "We can treat AIDS," says Desai, "with
kindness, with dignity, with love."
--
Greg (Gregory Loren) Pratt Rochester Institute of Technology
Snail: CPU 1519 25 Andrews Memorial Drive Rochester, NY 14623-5689 USA
glp5941@ultb.isc.rit.edu | GLP5941@ritvax.isc.rit.edu | GLP5941@RITVAX.BITNET